WHO Immunization Implementation Guide
0.1.0 - CI Build
WHO Immunization Implementation Guide
0.1.0 - CI Build
WHO Immunization Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-immunizations and changes regularly. See the Directory of published versions
XML representation of the IMMZD1ClientHistoryPolio questionnaire.
<Questionnaire xmlns="http://hl7.org/fhir">
<id value="IMMZD1ClientHistoryPolio"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-extr-smap"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description & Constraints</a><span style="float: right"><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> </td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Immunization - Capture Client History Questionnaire for Polio Immunization</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://smart.who.int/ig/smart-immunizations/Questionnaire/IMMZD1ClientHistoryPolio#0.1.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.birth" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> birth</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Indicates if the client received a dose within 24 hours of birth. Whether a birth dose is counted as part of the primary series will depend on the antigen.</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.type" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> type</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The type of dose in a series that the client received</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="ValueSet-IMMZD1ClientHistoryPolio_IMMZ.D1.DE103.html">IMMZ.D1.DE103 ValueSet for Type of dose</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.booster" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> booster</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Indicates if the client has completed the booster series of a product/antigen</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.completedPrimarySeries" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> completedPrimarySeries</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Indicates if the client has completed the primary vaccination series of a product/antigen. If the client has not yet completed their primary series, it means they may be expected to receive more doses to complete their vaccination regimen for the respective product/antigen.</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.dateSeriesCompleted" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Date" class="hierarchy"/> dateSeriesCompleted</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The date when the client completed the primary vaccination series - per product/antigen</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.hivStatus" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> hivStatus</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The current human immunodeficiency virus HIV status of the client</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="ValueSet-IMMZD1ClientHistoryPolio_IMMZ.D1.DE10.html">IMMZ.D1.DE10 ValueSet for HIV status</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.pretermBirth" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> pretermBirth</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The infant was preterm; the mother gave birth to the infant when gestational age was less than 37 weeks</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.immunocompromised" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: white; background-color: inherit" title="Boolean" class="hierarchy"/> immunocompromised</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The client is known to be immunocompromised. This means the client has a weakened immune system and having a reduced ability to fight infections and other diseases</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.onART" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-boolean.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Boolean" class="hierarchy"/> onART</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The client is currently receiving antiretroviral therapy - ART</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean">boolean</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.poliotype" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="Coding" class="hierarchy"/> poliotype</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The type of the polio vaccine dose administered to the client</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="ValueSet-IMMZD1ClientHistoryPolio_IMMZ.D1.DE35.html">IMMZ.D1.DE35 ValueSet for Type of polio dose</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item.artStartDate" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Date" class="hierarchy"/> artStartDate</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The date on which the client started or restarted antiretroviral therapy ART</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item.vaccineHistory" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-group.png" alt="." style="background-color: white; background-color: inherit" title="Group" class="hierarchy"/> vaccineHistory</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine History</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group">group</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" id="item.vaccineType" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Coding" class="hierarchy"/> vaccineType</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Vaccine type/category that was administered or was to be administered. Any vaccine code available in the IMMZ.Z Vaccine Library list of codes applies in this data element</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Value Set: <a href="ValueSet-IMMZD1ClientHistoryPolio_IMMZ.Z.DE23.html">IMMZ.Z.DE23 Yellow fever containing vaccines</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item.vaccineDate" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-date.png" alt="." style="background-color: white; background-color: inherit" title="Date" class="hierarchy"/> vaccineDate</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Represents the visit/encounter date, which is the date and time when the vaccine was administered to the client</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="http://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<contained>
<ValueSet>
<id value="IMMZ.D1.DE10"/>
<url
value="http://smart.who.int/ig/smart-immunizations/ValueSet/IMMZ.D1.DE10"/>
<name value="IMMZ_D1_DE10"/>
<title value="IMMZ.D1.DE10 ValueSet for HIV status"/>
<status value="active"/>
<experimental value="false"/>
<description value="ValueSet for HIV status for IMMZ.D1.DE10"/>
<compose>
<include>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<concept>
<code value="DE11"/>
<display value="HIV-positive"/>
</concept>
<concept>
<code value="DE12"/>
<display value="HIV-negative"/>
</concept>
<concept>
<code value="DE13"/>
<display value="Unknown"/>
</concept>
</include>
</compose>
</ValueSet>
</contained>
<contained>
<ValueSet>
<id value="IMMZ.D1.DE35"/>
<url
value="http://smart.who.int/ig/smart-immunizations/ValueSet/IMMZ.D1.DE35"/>
<name value="IMMZ_D1_DE35"/>
<title value="IMMZ.D1.DE35 ValueSet for Type of polio dose"/>
<status value="active"/>
<experimental value="false"/>
<description value="ValueSet for Type of polio dose for IMMZ.D1.DE35"/>
<compose>
<include>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<concept>
<code value="DE36"/>
<display value="IPV"/>
</concept>
<concept>
<code value="DE37"/>
<display value="bOPV"/>
</concept>
</include>
</compose>
</ValueSet>
</contained>
<contained>
<ValueSet>
<id value="IMMZ.D1.DE103"/>
<url
value="http://smart.who.int/ig/smart-immunizations/ValueSet/IMMZ.D1.DE103"/>
<name value="IMMZ_D1_DE103"/>
<title value="IMMZ.D1.DE103 ValueSet for Type of dose"/>
<status value="active"/>
<experimental value="false"/>
<description value="ValueSet for Type of dose for IMMZ.D1.DE103"/>
<compose>
<include>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<concept>
<code value="DE104"/>
<display value="Primary series"/>
</concept>
<concept>
<code value="DE105"/>
<display value="Dose 0"/>
</concept>
<concept>
<code value="DE106"/>
<display value="Supplementary dose"/>
</concept>
<concept>
<code value="DE107"/>
<display value="Booster dose"/>
</concept>
</include>
</compose>
</ValueSet>
</contained>
<contained>
<ValueSet>
<id value="IMMZ.Z.DE23"/>
<url
value="http://smart.who.int/ig/smart-immunizations/ValueSet/IMMZ.Z.DE23"/>
<name value="IMMZ_Z_DE23"/>
<title value="IMMZ.Z.DE23 Yellow fever containing vaccines"/>
<status value="active"/>
<experimental value="false"/>
<description value="Vaccine terminology codes for yellow fever."/>
<compose>
<include>
<system value="http://hl7.org/fhir/sid/icd-11"/>
<concept>
<code value="XM0N24"/>
<display value="Yellow fever vaccine"/>
</concept>
<concept>
<code value="XM3418"/>
<display value="Yellow fever, live attenuated"/>
</concept>
</include>
<include>
<system value="http://snomed.info/sct"/>
<concept>
<code value="836385002"/>
<display
value="Yellow fever virus antigen-containing vaccine product"/>
</concept>
<concept>
<code value="1121000221106"/>
<display
value="Live attenuated Yellow fever virus antigen only vaccine product"/>
</concept>
</include>
</compose>
</ValueSet>
</contained>
<extension
url="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-targetStructureMap">
<valueCanonical
value="http://smart.who.int/ig/smart-immunizations/StructureMap/IMMZD1PolioQRToResources"/>
</extension>
<url
value="http://smart.who.int/ig/smart-immunizations/Questionnaire/IMMZD1ClientHistoryPolio"/>
<version value="0.1.0"/>
<title value="Capture Client History Questionnaire - Polio"/>
<derivedFrom
value="http://smart.who.int/ig/smart-immunizations/Questionnaire/IMMZD1ClientHistory"/>
<status value="draft"/>
<subjectType value="Patient"/>
<date value="2024-05-30T21:26:16+00:00"/>
<publisher value="World Health Organization (WHO)"/>
<contact>
<name value="World Health Organization (WHO)"/>
<telecom>
<system value="url"/>
<value value="https://www.who.int"/>
</telecom>
</contact>
<description
value="Immunization - Capture Client History Questionnaire for Polio Immunization"/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<item>
<linkId value="birth"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE109"/>
</code>
<text
value="Indicates if the client received a dose within 24 hours of birth. Whether a birth dose is counted as part of the primary series will depend on the antigen."/>
<type value="boolean"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="type"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE103"/>
</code>
<text value="The type of dose in a series that the client received"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet value="#IMMZ.D1.DE103"/>
</item>
<item>
<linkId value="booster"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE102"/>
</code>
<text
value="Indicates if the client has completed the booster series of a product/antigen"/>
<type value="boolean"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="completedPrimarySeries"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE8"/>
</code>
<text
value="Indicates if the client has completed the primary vaccination series of a product/antigen. If the client has not yet completed their primary series, it means they may be expected to receive more doses to complete their vaccination regimen for the respective product/antigen."/>
<type value="boolean"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="dateSeriesCompleted"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE81"/>
</code>
<text
value="The date when the client completed the primary vaccination series - per product/antigen"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="hivStatus"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE10"/>
</code>
<code>
<system value="http://loinc.org"/>
<code value="55277-8"/>
</code>
<code>
<system value="http://snomed.info/sct"/>
<code value="278977008"/>
</code>
<text
value="The current human immunodeficiency virus HIV status of the client"/>
<type value="choice"/>
<required value="false"/>
<repeats value="false"/>
<answerValueSet value="#IMMZ.D1.DE10"/>
</item>
<item>
<linkId value="pretermBirth"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE15"/>
</code>
<code>
<system value="http://hl7.org/fhir/sid/icd-11"/>
<code value="KA21.4"/>
</code>
<code>
<system value="http://loinc.org"/>
<code value="76517-2"/>
</code>
<code>
<system value="http://snomed.info/sct"/>
<code value="395507008"/>
</code>
<text
value="The infant was preterm; the mother gave birth to the infant when gestational age was less than 37 weeks"/>
<type value="boolean"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="immunocompromised"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE16"/>
</code>
<code>
<system value="http://hl7.org/fhir/sid/icd-11"/>
<code value="4B4Z"/>
</code>
<code>
<system value="http://loinc.org"/>
<code value="96381-9"/>
</code>
<code>
<system value="http://snomed.info/sct"/>
<code value="370388006"/>
</code>
<text
value="The client is known to be immunocompromised. This means the client has a weakened immune system and having a reduced ability to fight infections and other diseases"/>
<type value="boolean"/>
<required value="true"/>
<repeats value="false"/>
</item>
<item>
<linkId value="onART"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE17"/>
</code>
<text
value="The client is currently receiving antiretroviral therapy - ART"/>
<type value="boolean"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="poliotype"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE35"/>
</code>
<text
value="The type of the polio vaccine dose administered to the client"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet value="#IMMZ.D1.DE35"/>
</item>
<item>
<linkId value="artStartDate"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D1"/>
<code value="DE49"/>
</code>
<text
value="The date on which the client started or restarted antiretroviral therapy ART"/>
<type value="date"/>
<required value="false"/>
<repeats value="false"/>
</item>
<item>
<linkId value="vaccineHistory"/>
<text value="Vaccine History"/>
<type value="group"/>
<required value="false"/>
<repeats value="true"/>
<item>
<linkId value="vaccineType"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D"/>
<code value="DE19"/>
</code>
<code>
<system value="http://loinc.org"/>
<code value="39236-5"/>
</code>
<code>
<system value="http://snomed.info/sct"/>
<code value="787859002"/>
</code>
<text
value="Vaccine type/category that was administered or was to be administered. Any vaccine code available in the IMMZ.Z Vaccine Library list of codes applies in this data element"/>
<type value="choice"/>
<required value="true"/>
<repeats value="false"/>
<answerValueSet value="#IMMZ.Z.DE23"/>
</item>
<item>
<linkId value="vaccineDate"/>
<code>
<system
value="http://smart.who.int/ig/smart-immunizations/CodeSystem/IMMZ.D"/>
<code value="DE20"/>
</code>
<code>
<system value="http://loinc.org"/>
<code value="30952-6"/>
</code>
<text
value="Represents the visit/encounter date, which is the date and time when the vaccine was administered to the client"/>
<type value="date"/>
<required value="true"/>
<repeats value="false"/>
</item>
</item>
</Questionnaire>